Tumor site and disease stage as predictors of quality of life in head and neck cancer: a prospective study on patients treated with surgery or combined therapy with surgery and radiotherapy or radiochemotherapy.

Related Articles

Tumor site and disease stage as predictors of quality of life in head and neck cancer: a prospective study on patients treated with surgery or combined therapy with surgery and radiotherapy or radiochemotherapy.

Eur Arch Otorhinolaryngol. 2016 Jan;273(1):215-24

Authors: Veldhuis D, Probst G, Marek A, Noack V, Ural A, Adamietz I, Dazert S, Minovi A

Abstract
In this prospective study, we compared the short-term quality of life (QOL) of two subgroups of head and neck cancers: oropharyngeal and laryngeal cancers. Patients treated with curative surgery, were asked to participate in the study using the EORTC QLQ-C30 and H&N35 questionnaires to examine QOL. The oropharynx group consisted of 32 (48 %) patients, while the larynx group consisted of 35 (52 %) patients. All patients were treated with either curative surgery alone or curative surgery combined with adjuvant radiotherapy or radiochemotherapy. The questionnaires were handed out pre- and post-therapy (10 months). At baseline, an impaired overall QOL (=EORTC QLQ-C30 global score) with a value of 53.4 for the whole patient collective was found; the overall QOL after 10 months improved (60.2, p < 0.05). Between the two patient groups, there was no difference in the global score after 10 months. The oropharynx patients described more problems with fatigue and oral cavity associated. The main symptoms in the larynx group were loss of sensual function and coughing. The present investigation revealed that the general post-therapy QOL in two subgroups of head and neck cancer reached a satisfying level.

PMID: 25575842 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b7vz4z
via IFTTT

The role of long non-coding RNA HOTAIR in the progression and development of laryngeal squamous cell carcinoma interacting with EZH2.

The role of long non-coding RNA HOTAIR in the progression and development of laryngeal squamous cell carcinoma interacting with EZH2.

Acta Otolaryngol. 2016 Aug 19;:1-9

Authors: Zheng J, Xiao X, Wu C, Huang J, Zhang Y, Xie M, Zhang M, Zhou L

Abstract
CONCLUSIONS: The aberrant expression of long non-coding RNA HOTAIR and transmethylase EZH2 played important roles in the progression and development of laryngeal squamous cell carcinoma (LSCC).
OBJECTIVES: This research was aimed to explore the expression and correlation with clinicopathological characteristics of HOTAIR and EZH2 in LSCC, and to evaluate the function of the two in regulating the proliferation and cis-platinum resistance processes of LSCC.
METHODS: Quantitative real time-PCR (qPCR) was conducted to measure the expression of HOTAIR and EZH2 in tissue samples. Clinicopathological features were collected and statistically analyzed combining with the expression of HOTAIR and EZH2. The variance of EZH2 with down-regulating HOTAIR was measured by qPCR. CCK-8 proliferation test was conducted to detect the proliferation feature in LSCC cells. After cultured with a series of cis-platinum concentrations for 24 h, cell viability was detected using CCK-8 assay, and the inhibition rates were calculated.
RESULTS: HOTAIR and EZH2 were over-expressed in LSCC tissue. The higher expression was significantly related to T phase, pathological grades, and risk of lymphatic metastasis of LSCC. Suppressing HOTAIR expression stimulated EZH2 expressing, promoted the proliferation of AMC-HN8 cells, and increased the sensitivity to cis-platinum of the LSCC cells.

PMID: 27542077 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b7dtQ7
via IFTTT

Taste disturbance after stapes surgery: an evaluation of frequency, severity, duration, and quality-of-life.

Taste disturbance after stapes surgery: an evaluation of frequency, severity, duration, and quality-of-life.

Acta Otolaryngol. 2016 Aug 19;:1-5

Authors: Berling Holm K, Knutsson J, Strömbäck K, Danckwardt Lillieström N, Papatziamos G, Rosenblad A, Von Unge M

Abstract
CONCLUSION: The incidence of taste disturbance after stapes surgery is high (61.9%), whereas the majority (94.8%) recovers within 1 year. More severe surgical nerve trauma caused more disturbance, implying that the nerve should be handled carefully during surgery.
OBJECTIVES: Patients operated on for otosclerosis seem more often to complain about post-operative taste disturbance than those operated on for chronic otitis media, although the chorda tympani nerve more seldom becomes maltreated in stapedotomy. These observations seem paradoxical. It is unclear to what extent a post-operative taste disturbance affects the quality-of-life. This study aims to shed light on the occurrence of post-operative taste disturbances, on possible prognostic factors, and to what extent post-operative taste disturbance impairs the quality-of-life.
METHODS: One hundred and thirty-four adults undergoing primary stapedotomy were included. Questionnaires on taste disturbance and quality-of-life (SF-36) were answered before and after surgery, until 1 year post-operatively.
RESULTS: Eighty-three (61.9%) study persons reported post-operative taste disturbance. Seven (5.2%) reported persisting disturbance at 1 year. Surgically more traumatized chorda tympani nerves correlated with more severe taste disturbance post-operatively than less traumatized. Taste disturbance at 1 year post-operatively correlate with a decrease of the physical function domain in the SF-36.

PMID: 27540683 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bpJwxL
via IFTTT

Five-year prospective evaluation of thyroid function test evolution in children with Hashimoto's thyroiditis presenting with either euthyroidism or subclinical hypothyroidism.

Five-year prospective evaluation of thyroid function test evolution in children with Hashimoto's thyroiditis presenting with either euthyroidism or subclinical hypothyroidism.

Thyroid. 2016 Aug 19;

Authors: Aversa T, Corrias A, Salerno M, Tessaris D, Di Mase R, Valenzise M, Corica D, De Luca F, Wasniewska M

Abstract
BACKGROUND: Whether the course of thyroid function in Hashimoto's thyroiditis (HT) differs in children who present with either euthyroidism or subclinical hypothyroidism (SH) has been incompletely investigated.
AIM: To investigate, by means of a 5-year prospective evaluation of 234 children with HT and no prognostic risk factors, whether the evolution of the thyroid status is influenced by the biochemical pattern at initial diagnosis.
RESULTS: In the entire series, TSH values significantly increased during follow-up, whilst FT4 values decreased and the proportion of children with a thyroid dysfunction increased from 27.3 to 47.4% (p=0.0001). An increasing proportion of cases with severe thyroid dysfunction was identified, especially among the 64 patients presenting with SH (group B), but also among the 170 children presenting with euthyroidism (group A) at initial diagnosis. At the end of follow-up, the prevalence of children with overt hypothyroidism was 12.3% in group A vs 31.2% in group B (p=0.0007). In the overall population, however, the majority of patients (52.6%) exhibited, at the end of follow-up, biochemical euthyroidism.
CONCLUSIONS: a) children with HT may develop during the first 5 years of disease a deterioration of thyroid status; b) such a trend may be observed even in the patients who initially present with a mild biochemical picture (either SH or euthyroidism); c) 57.1% of initially euthyroid children remain euthyroid, and d) 40.6% of patients with initial SH normalize thyroid function within 5 years after HT diagnosis; e) the patients presenting with SH are more prone to the risk of developing severe thyroid dysfunction over time.

PMID: 27541075 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2btaeIo
via IFTTT

Prognostic factors for early and long-term remission in pediatric differentiated thyroid cancer: the role of gender, age, clinical presentation and the newly proposed American Thyroid Association risk stratification system.

Prognostic factors for early and long-term remission in pediatric differentiated thyroid cancer: the role of gender, age, clinical presentation and the newly proposed American Thyroid Association risk stratification system.

Thyroid. 2016 Aug 19;

Authors: Pires B, Alves-Junior PA, Bordallo MA, Bulzico DA, Coeli CM, de Oliveira RV, Santos IC, Farias T, Dias FL, Lima RA, Lopes F, Corbo R, Vaisman M, Vaisman F

Abstract
BACKGROUND: The incidence of pediatric differentiated thyroid carcinoma (DTC) has been rising in recent years, and the main risk factors for recurrence are lymph node and distant metastasis at diagnosis. Other clinical features remain unclear, such as the impact of age, gender and puberty. Furthermore, until now, this population has been treated using the same strategies used to treat adults. In 2015, the American Thyroid Association (ATA) published the first guidelines targeted to this age group. The aim of this study is to investigate the prognostic factors for early and long-term remission and also validate the ATA risk stratification proposal in a population outside the US.
METHODS: Clinical records from 118 patients <18 years old followed in two referral centers were reviewed.
RESULTS: The median age was 12 (4-18) years, and 20.3% (24 patients) were less than 10 years old at diagnosis, with a median follow-up of 9.1 years. The majority were female (72%), received total thyroidectomy and radioiodine therapy (RAI), and 61.8% underwent more than one dose of RAI. The majority were classified as high risk (48.3%) by the new ATA pediatric guidelines due to distant metastasis (30 patients) or extensive lymph node involvement (27 patients), followed by low risk (31.3%) and intermediate (20.4%). Females with no lymph node or distant metastasis and low ATA pediatric risk were more likely to have no evidence of disease (p<0.05) within the first year and also in the long term. In our study, age did not significantly predict outcomes. Furthermore, patients also benefitted from multiple doses of RAI, but when the cumulative activity was above 400 mCi, this benefit was diminished.
CONCLUSIONS: This study showed that the ATA risk stratification proposal for pediatric patients is useful in predicting early and long-term outcomes in pediatric patients with DTC. In addition, we showed that gender and metastatic disease are important prognostic factors in pediatric populations.

PMID: 27540892 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b7SG2g
via IFTTT

A GOITER IN CHRIST IN CRUCIFIXION.

A GOITER IN CHRIST IN CRUCIFIXION.

Thyroid. 2016 Aug 18;

Authors: Pozzilli P, Lazzeri D

PMID: 27539119 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bpWaec
via IFTTT

Association between serum thyrotropin levels and mortality among euthyroid adults in the United States.

Association between serum thyrotropin levels and mortality among euthyroid adults in the United States.

Thyroid. 2016 Aug 18;

Authors: Inoue K, Tsujimoto T, Saito J, Sugiyama T

Abstract
BACKGROUND: Low thyroid function within the euthyroid range, as well as overt and subclinical hypothyroidism, reportedly increases the risk of cardiovascular disease and mortality. However, the association between low normal thyroid function and mortality remains controversial. This study was performed to elucidate the association between low normal thyroid function and all-cause and/or cause-specific mortalities among US adults.
METHODS: We conducted a prospective cohort study using a nationally representative sample of 12,584 US adults aged ≥ 20 years with TSH levels within the normal range from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994). Associations between TSH tertiles (high, medium, and low normal TSH groups) and mortalities (all-cause, cardiovascular and cancer) were investigated using multivariable Cox models. Stratum-specific analyses were estimated within subgroups defined according to sex (male or female) and baseline age (age < 60 years or age ≥ 60 years). We further conducted the same analysis using continuous NHANES 2001-2002, 2007-2008, and 2009-2010 cohorts which included data of FT4 levels.
RESULTS: Median follow-up period was 19.1 years, with 3,395 all-cause deaths. A significantly higher risk of all-cause mortality (adjusted hazard ratio [HR], 1.27; 95% confidence interval [CI], 1.10-1.47) and cardiovascular (HR, 1.30; 95% CI, 1.02-1.67) and cancer mortality (HR, 1.43; 95% CI, 1.01-2.01) was observed in the high normal TSH group than in the medium normal TSH group. Additionally, the low normal TSH group had an increased risk of all-cause mortality. In stratum-specific analyses, we found a significant association between high normal TSH levels and all-cause mortality among males, females, and participants < 60 years. Continuous NHANES cohorts demonstrated a non-significant increase in the HR for all-cause mortality in the high normal TSH group.
CONCLUSIONS: High normal TSH levels compared with medium normal TSH levels were associated with increased risk of all-cause, cardiovascular, and cancer mortalities over a long-term follow-up period among US adults. This study indicated that the normal range of TSH levels may require reevaluation.

PMID: 27539006 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bBplLx
via IFTTT

Unexpected elevated free thyroid hormones in pregnancy.

Unexpected elevated free thyroid hormones in pregnancy.

Thyroid. 2016 Aug 18;

Authors: Teti C, Nazzari E, Galletti M, Mandolfino MG, Pupo F, Pesce G, Lillo F, Bagnasco M, Benvenga S

Abstract
BACKGROUND: The use of thyrotropin and free thyroid hormone assays to evaluate thyroid function is widespread, but in some situations the results are inconsistent with the patient's thyroid status.
SUMMARY: A 35-year-old woman with a known diagnosis of chronic autoimmune thyroiditis was referred to us at week 26 of her second pregnancy. The patient was clinically euthyroid; consistent with this, her serum TSH was normal (0.79 mU/L), but she had elevated free thyroid hormones (fT3, fT4), as determined by a one-step chemiluminescent assay. The patient was taking levothyroxine replacement therapy (125 µg/d) and the dose was confirmed. Previous blood tests showed concordance between TSH and free thyroid hormone values. We followed up the patient throughout gestation and 12 months postpartum. During gestation, her free thyroid hormones remained high using one-step methods, while the total thyroid hormone concentration were within the reference range, in agreement with the TSH values. Post partum fT4 and fT3 values returned progressively to normality, in agreement with the TSH values. We hypothesized the presence of circulating thyroid hormone autoantibodies (THAb), which are known to interfere, although to a variable extent, with thyroid hormone one-step assays. Using stored frozen sera, we were able to confirm this hypothesis indirectly by measuring normal levels of FT3 and FT4 with a two-step method, and directly by demonstrating THAb against the two hormones.
CONCLUSIONS: Despite their relative rarity, circulating THAb may be suspected when laboratory data are not consistent and contrast with the clinical picture. To our knowledge, no previous case of transient appearance of THAb in pregnancy has been described.

PMID: 27538922 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bt9Qtc
via IFTTT

Palato-maxillary reconstruction by the angular branch-based tip of scapula free flap.

Palato-maxillary reconstruction by the angular branch-based tip of scapula free flap.

Eur Arch Otorhinolaryngol. 2016 Aug 18;

Authors: Piazza C, Paderno A, Del Bon F, Taglietti V, Grammatica A, Montalto N, Nicolai P

Abstract
The angular branch (AB)-based tip of scapula free flap is a valuable reconstructive option in palato-maxillary defects needing significant structural support. We herein retrospectively evaluate our surgical series with special focus on functional outcomes and postoperative morbidity. Ninety-seven consecutive palatomaxillary oncologic resections were performed at our institution between August 2008 and November 2015. The analysis focused on those reconstructed by an AB-based tip of scapula free flap (N = 18; 19 %). A prospective assessment of donor site morbidity was performed by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire in 12 (67 %) patients. Among patients reconstructed by an AB-based tip of scapula free flap, 13 (72 %) had a Class II and 5 (28 %) a Class III defect according to Okay classification. Flap success rate was 94 %, with one failure requiring an anterolateral thigh flap. Eight (44 %) patients experienced recipient site complications, while donor site problems occurred in two only (11 %). Eleven (61 %) subjects were able to maintain a normal and 7 (39 %) a soft-to-firm diet. The mean DASH score was 10.5. Our results confirm that the AB-based tip of scapula free flap is a reliable choice in palatomaxillary reconstruction, with both satisfactory functional outcomes and negligible donor site morbidity.

PMID: 27538738 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5L7uE
via IFTTT

Aspirin-exacerbated respiratory disease and current treatment modalities.

Aspirin-exacerbated respiratory disease and current treatment modalities.

Eur Arch Otorhinolaryngol. 2016 Aug 18;

Authors: Sakalar EG, Muluk NB, Kar M, Cingi C

Abstract
Aspirin-exacerbated respiratory disease (AERD) refers to the combination of asthma, chronic rhinosinusitis with nasal polyposis, and acute upper and lower respiratory tract reactions to the ingestion of aspirin (acetylsalicylic acid, ASA) and other cyclooxygenase-1 inhibiting non-steroidal anti-inflammatory drugs. AERD affects 0.3-0.9 % of the general population. AERD generally occurs due to abnormalities in mediators and expression of arachidonic acid biosynthesis. Local IgE responses to staphylococcal enterotoxins may also be responsible for eosinophilic activation in the nasal polyp tissues of AERD patients. Clinical features of AERD include the onset of nasal congestion with anosmia, progressing to chronic pansinusitis and nasal polyps that regrow rapidly after surgery. Aspirin desensitization, Leukotriene-modifying agents, biologic agents, management of asthma, chronic rhinosinusitis, and nasal polyposis are recommended as treatment modalities. Immunotherapy is prescribed only to those AERD patients who experience clear seasonal or perennial allergy symptoms in addition to the symptoms attributable to chronic nasal polyposis. There are also investigational and dietary therapies. In this review, the important aspects of AERD will be presented, along with a literature survey.

PMID: 27538737 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bpNIO5
via IFTTT

Bacterial findings in optimised sampling and characterisation of S. aureus in chronic rhinosinusitis.

Bacterial findings in optimised sampling and characterisation of S. aureus in chronic rhinosinusitis.

Eur Arch Otorhinolaryngol. 2016 Aug 18;

Authors: Thunberg U, Söderquist B, Hugosson S

Abstract
The bacterial spectrum in chronic rhinosinusitis (CRS) is clinically relevant. This study aimed to compare two sampling techniques and to characterise Staphylococcus aureus isolated from CRS patients. Bacterial specimens were collected from the nares and maxillary sinus in 42 CRS patients and from the nares in 57 healthy controls. Maxillary sinus sampling was performed in two ways in each patient: with a cotton-tipped aluminium swab through the enlarged sinus ostium, and with a protected brush. S. aureus was characterised by DNA-sequencing of the repeat region of the S. aureus protein A gene, spa typing. The protected brush technique was superior to the cotton-tipped aluminium swab in reducing contamination rate. However, the two sampling methods were consistent in terms of clinically relevant bacterial findings, and the easy-to-handle cotton-tipped swab can still be recommended when culturing the maxillary sinus. Patients showed a significantly higher presence of S. aureus in the nares compared with healthy controls, and healthy controls showed a significantly higher presence of coagulase-negative staphylococci in the nares compared with patients. The spa types were identical for the nares and maxillary sinus in all patients except one. The sampling techniques showed equivalent results, indicating a low risk of unnecessary antibiotic treatment when using the easy-to-handle cotton-tipped aluminium swab. The high rate of identical spa types of S. aureus isolated from the nares and maxillary sinus of CRS patients might indicate colonisation of the maxillary sinus from the nares.

PMID: 27538736 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5M6uG
via IFTTT

Psychosocial development of 5-year-old children with hearing loss: Risks and protective factors.

Psychosocial development of 5-year-old children with hearing loss: Risks and protective factors.

Int J Audiol. 2016 Aug 19;:1-12

Authors: Wong CL, Ching TY, Leigh G, Cupples L, Button L, Marnane V, Whitfield J, Gunnourie M, Martin L

Abstract
OBJECTIVE: The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes.
DESIGN: A cross-sectional analysis of data collected from a prospective, population-based longitudinal study.
STUDY SAMPLE: Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4).
RESULTS: On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not.
CONCLUSION: The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development.

PMID: 27541363 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b7TBzB
via IFTTT

[Speaker discrimination in cochlear implant users].

[Speaker discrimination in cochlear implant users].

HNO. 2016 Aug 18;

Authors: Mühler R, Ziese M, Verhey JL

Abstract
BACKGROUND: Although the word and sentence recognition skills of cochlear implant (CI) users have been studied extensively, little is known about their ability to distinguish between individuals on the basis of voice, an important skill for social communication.
METHODS: Speech material from the Oldenburg Logatome Corpus (OLLO) was used to build a set of 120 logatome pairs spoken by 15 male and 15 female speakers, with no overlap of the fundamental frequencies of the two groups of speakers. Each pair contained two different logatomes. For half of the pairs, the two logatomes were spoken by the same speaker, for the other half they were spoken by different speakers. Using a same-different paradigm, 13 adult normal-hearing listeners and 13 adult post-lingually deafened CI users were asked whether the pair of different logatomes were spoken by the same or by different speakers.
RESULTS: Mean speaker discrimination score for the CI users was 74.6 % correct and for the normal-hearing listeners 89.6 % correct. A significant influence of voice gender on speaker discrimination score was found in CI users and in normal hearing listeners.
CONCLUSION: The results of the CI users were significantly above the level of chance and no ceiling effect was observed for the normal-hearing listeners, i. e., the presented set of logatome pairs from the OLLO seems to be very well suited to speaker discrimination experiments in CI users and quantitative comparison to normal-hearing listeners. CI users are able to discriminate between speakers but their performance is slightly worse than that of normal-hearing listeners.

PMID: 27538938 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bt4UEy
via IFTTT

[Characteristics, advantages, and limits of matrix tests].

[Characteristics, advantages, and limits of matrix tests].

HNO. 2016 Aug 18;

Authors: Brand T, Wagener KC

Abstract
BACKGROUND: Deterioration of communication abilities due to hearing problems is particularly relevant in listening situations with noise. Therefore, speech intelligibility tests in noise are required for audiological diagnostics and evaluation of hearing rehabilitation.
OBJECTIVE: This study analyzed the characteristics of matrix tests assessing the 50 % speech recognition threshold in noise. What are their advantages and limitations?
METHODS: Matrix tests are based on a matrix of 50 words (10 five-word sentences with same grammatical structure). In the standard setting, 20 sentences are presented using an adaptive procedure estimating the individual 50 % speech recognition threshold in noise. At present, matrix tests in 17 different languages are available.
RESULTS: A high international comparability of matrix tests exists. The German language matrix test (OLSA, male speaker) has a reference 50 % speech recognition threshold of -7.1 (± 1.1) dB SNR.
CONCLUSION: Before using a matrix test for the first time, the test person has to become familiar with the basic speech material using two training lists. Hereafter, matrix tests produce constant results even if repeated many times. Matrix tests are suitable for users of hearing aids and cochlear implants, particularly for assessment of benefit during the fitting process. Matrix tests can be performed in closed form and consequently with non-native listeners, even if the experimenter does not speak the test person's native language. Short versions of matrix tests are available for listeners with a shorter memory span, e.g., children.

PMID: 27538937 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b7fYlp
via IFTTT

[Cochlear implant fitting strategies].

[Cochlear implant fitting strategies].

HNO. 2016 Aug 18;

Authors: Hoppe U, Liebscher T, Hornung J

Abstract
Cochlear implant (CI) fitting is the technical adjustment of a CI processor to the individual needs of a subject. Fitting comprises the choice of stimulation strategy and determination of the lower and upper stimulation levels for the individual. This electrical dynamic range defines the stimulation range for the real-time functioning of the CI system. All of the CI manufacturers provide a large set of parameters which have to be optimized for proper hearing and speech comprehension. As a consequence of the widening of indication criteria for CIs and lowering the age of implantation for children, the fitting process has changed dramatically over the years. This includes replacement of behavioral responses by other data from objective electrophysiologic measures and from expert knowledge. Recent developments aim to structure and automatize the CI fitting process. This reduces the time requirement for CI fitting and leads to fast settings which can be tested in the real-time situation. This review provides an overview of state-of-the-art fitting procedures and recent developments for fitting strategies. These will be discussed with respect to practicability and quality assurance.

PMID: 27538936 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bt8vTm
via IFTTT

Psychosocial development of 5-year-old children with hearing loss: Risks and protective factors.

Psychosocial development of 5-year-old children with hearing loss: Risks and protective factors.

Int J Audiol. 2016 Aug 19;:1-12

Authors: Wong CL, Ching TY, Leigh G, Cupples L, Button L, Marnane V, Whitfield J, Gunnourie M, Martin L

Abstract
OBJECTIVE: The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes.
DESIGN: A cross-sectional analysis of data collected from a prospective, population-based longitudinal study.
STUDY SAMPLE: Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4).
RESULTS: On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not.
CONCLUSION: The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development.

PMID: 27541363 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b7TBzB
via IFTTT

Psychological Therapy for People with Tinnitus: A Scoping Review of Treatment Components.

Psychological Therapy for People with Tinnitus: A Scoping Review of Treatment Components.

Ear Hear. 2016 Aug 18;

Authors: Thompson DM, Hall DA, Walker DM, Hoare DJ

Abstract
BACKGROUND: Tinnitus is associated with depression and anxiety disorders, severely and adversely affecting the quality of life and functional health status for some people. With the dearth of clinical psychologists embedded in audiology services and the cessation of training for hearing therapists in the UK, it is left to audiologists to meet the psychological needs of many patients with tinnitus. However, there is no universally standardized training or manualized intervention specifically for audiologists across the whole UK public healthcare system and similar systems elsewhere across the world.
OBJECTIVES: The primary aim of this scoping review was to catalog the components of psychological therapies for people with tinnitus, which have been used or tested by psychologists, so that they might inform the development of a standardized audiologist-delivered psychological intervention. Secondary aims of this article were to identify the types of psychological therapy for people with tinnitus, who were reported but not tested in any clinical trial, as well as the job roles of clinicians who delivered psychological therapy for people with tinnitus in the literature.
DESIGN: The authors searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; Cochrane Central Register of Controlled Trials; PubMed; EMBASE; CINAHL; LILACS; KoreaMed; IndMed; PakMediNet; CAB Abstracts; Web of Science; BIOSIS Previews; ISRCTN; ClinicalTrials.gov; IC-TRP; and Google Scholar. In addition, the authors searched the gray literature including conference abstracts, dissertations, and editorials. No records were excluded on the basis of controls used, outcomes reached, timing, setting, or study design (except for reviews-of the search results. Records were included in which a psychological therapy intervention was reported to address adults (≤18 years) tinnitus-related distress. No restrictive criteria were placed upon the term tinnitus. Records were excluded in which the intervention included biofeedback, habituation, hypnosis, or relaxation as necessary parts of the treatment.
RESULTS: A total of 5043 records were retrieved of which 64 were retained. Twenty-five themes of components that have been included within a psychological therapy were identified, including tinnitus education, psychoeducation, evaluation treatment rationale, treatment planning, problem-solving behavioral intervention, thought identification, thought challenging, worry time, emotions, social comparison, interpersonal skills, self-concept, lifestyle advice, acceptance and defusion, mindfulness, attention, relaxation, sleep, sound enrichment, comorbidity, treatment reflection, relapse prevention, and common therapeutic skills. The most frequently reported psychological therapies were cognitive behavioral therapy, tinnitus education, and internet-delivered cognitive behavioral therapy. No records reported that an audiologist delivered any of these psychological therapies in the context of an empirical trial in which their role was clearly delineated from that of other clinicians.
CONCLUSIONS: Scoping review methodology does not attempt to appraise the quality of evidence or synthesize the included records. Further research should therefore determine the relative importance of these different components of psychological therapies from the perspective of the patient and the clinician.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

PMID: 27541331 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bpKUAi
via IFTTT

Fibromyalgia syndrome and Temporomandibular disorders with muscular pain. A review.

Fibromyalgia syndrome and Temporomandibular disorders with muscular pain. A review.

Mod Rheumatol. 2016 Aug 19;:1-22

Authors: Moreno-Fernández AM, Jiménez-Castellanos E, Iglesias-Linares A, Bueso-Madrid D, Fernández-Rodríguez A, de Miguel M

Abstract
OBJECTIVES: Temporomandibular disorders (TMD) refer to a group of clinical picture affecting the masticatory muscles and temporomandibular joint that are characterized by muscular or joint pain, dysfunction (limited or altered functions) and joint noises, as well as other associated symptoms, such as tension headaches, otalgia, dizziness, tinnitus and others. Fibromyalgia (FM) is a syndrome of unknown etiology involving generalized chronic pain accompanied, in a high percentage of cases, by other symptoms such as asthenia, anxiety, depression, sleep disturbances and other less frequent symptoms, such as temporomandibular disorders (TMD).
DATA: data were compiled by two experienced examiners following a specific form.
SOURCES: An electronic search was carried out in the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, and SCOPUS electronic databases (up to April 2016, unrestricted by date or language) Study selection: comparative clinical studies with patients with both clinical pictures involving the study of pathogenic processes.
CONCLUSIONS: Fibromyalgia and temporomandibular disorders with muscle pain both have profiles that affect the muscular system and therefore share many epidemiological, clinical and physiopathological symptoms. Because of this, we are led to think that there is, if not a common etiology, at least a common pathogenesis. This article revises the physiopathological processes of both clinical pictures in an attempt to determine their similarities and likenesses. This would undoubtedly help in providing a better therapeutic approach.

PMID: 27539739 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5Kp0f
via IFTTT

A rare location for sarcoma metastasis: The temporal bone.

Related Articles

A rare location for sarcoma metastasis: The temporal bone.

Am J Otolaryngol. 2015 Nov-Dec;36(6):772-7

Authors: Hızlı Ö, Salduz A, Kaya S, Paparella MM, Cureoglu S

Abstract
Skeletal sarcoma metastasis is relatively rare; moreover, for this type of metastasis, the temporal bone is also a rare location. The temporal bone appears to be affected by metastatic tumors in discrete histopathologic patterns, with characteristic clinical presentations. In this study, we analyzed the records of 6 patients with skeletal sarcoma metastasis to the temporal bone, with an emphasis on histopathologic sections of human temporal bones. The most common site of sarcoma metastasis in the temporal bone was petrous apex in our series. Physicians should keep in mind that a sarcoma patient may manifest with ear findings due to temporal bone metastasis.

PMID: 26545469 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bpJDtd
via IFTTT

The sellar and suprasellar region: A "hideaway" of rare lesions. Clinical aspects, imaging findings, surgical outcome and comparative analysis.

The sellar and suprasellar region: A "hideaway" of rare lesions. Clinical aspects, imaging findings, surgical outcome and comparative analysis.

Clin Neurol Neurosurg. 2016 Aug 12;149:154-165

Authors: Petrakakis I, Pirayesh A, Krauss JK, Raab P, Hartmann C, Nakamura M

Abstract
OBJECTIVE: Apart from the "common" lesions (e.g. pituitary adenomas, Rathke's cleft cysts, meningiomas and craniopharyngiomas), there is a plethora of rare tumors or tumor-mimicking lesions in the sellar and suprasellar region (SSR). Due to a lack of characteristic imaging features, there is a dilemma in distinguishing these rare lesions from the more "common" ones preoperatively. Consequently, both diagnosis and definition of surgical goals, as well as further treatment strategies continue to be challenging for all attending physicians. To replenish the scarce data on this issue, we analysed all patients with infrequent non-adenomatous pathologies in the SSR treated in our clinic, providing a database for further studies.
METHODS: A retrospective study was performed including 223 patients who were operated on lesions within the SSR at the Department of Neurosurgery, Hannover Medical School, between 2006 and 2014. The patients' charts were analysed with regard to the results of pre-/postoperative endocrinological and neuroophthalmological examinations. Preoperative T2WI were analysed with special focus on distinct growth patterns within four quadrants constituting the (supra-)sellar region. In this way, a comparative analysis between the diverse lesions regarding their clinical features, resectability and the final outcome was possible.
RESULTS: After exclusion of cases with "common" lesions, a collective of 20 patients with rare lesions within the SSR was obtained. The histopathological diagnosis revealed xanthogranulomas (n=6), metastatic tumors (n=5), colloid/epidermal cysts (n=3), pilocytic astrocytomas (n=2), and one case each of gangliocytoma, lymphocytic hypophysitis or concomitant germ cell tumor/rhabdomyosarcoma. In comparison to non-infiltrative lesions, those of infiltrative nature caused more frequently diplopia and deterioration of visual acuity (4 cases; p<0,05) that were less prone to improve postoperatively. Regarding growth pattern, metastatic tumors demonstrated main growth within the third quadrant with destructive remodelling of the dorsum sellae (p<0,05). While patients harbouring large lesions (>20mm) showed a significantly worse outcome regarding hormonal deficits (p=0,0313), the overall prognosis was heavily linked to the histopathological diagnosis.
CONCLUSION: The correlation of the subtle radiological findings demonstrated with the specific clinical features may facilitate the differential diagnosis of rare lesions of the SSR and aid in establishing an interdisciplinary diagnostic and therapeutic procedure for these lesions.

PMID: 27540757 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5IEjB
via IFTTT

Functional state of the Hsp27 chaperone as a molecular marker of an unfavorable course of larynx cancer.

Functional state of the Hsp27 chaperone as a molecular marker of an unfavorable course of larynx cancer.

Cancer Biomark. 2016 Jun 24;17(2):145-153

Authors: Kaigorodova EV, Zavyalova MV, Bychkov VA, Perelmuter VM, Choynzonov EL

Abstract
BACKGROUND: The small heat shock protein 27 kDA (Hsp27) acts as an ATP-independent chaperone in protein folding, but is also implicated in architecture of the cytoskeleton, cell migration, metabolism, cell survival, growth/differentiation, mRNA stabilization, and tumor progression.
OBJECTIVE: To study the intracellular localization of phosphorylated and non-phosphorylated forms of Hsp27 in squamous cell carcinoma of the larynx (SCCL) and to evaluate their relationship with regional lymphatic metastasis and overall five-year survival.
METHODS: Tumor biopsies of larynx tissue were collected from 50 patients who were between the ages of 30 to 80 years and had a confirmed diagnosis of squamous cell carcinoma of the larynx. Immunohistochemistry was used to determine the intracellular localization of the phosphorylated and non-phosphorylated forms of Hsp27.
RESULTS: The study revealed that the Hsp27 chaperone was expressed in both the cytoplasm and the nucleus of tumor cells in SCCL. The biopsies of patients with lymph node metastases showed significantly higher expression of the phosphorylated and unphosphorylated forms of Hsp27 in the nucleus compared to those of patients without lymph node metastases. At the same time, the cytoplasmic expression of Hsp27 in these patients did not differ statistically. Analysis of the overall five-year survival rates showed that negative Hsp27 expression in the nucleus of tumor cells is associated with the survival rate of patients with SCCL.
CONCLUSION: The nuclear expression of phosphorylated and unphosphorylated forms of Hsp27 is a molecular marker of unfavorable squamous cell carcinoma of the larynx associated with lymphogenous metastasis and decreased total five-year survival.

PMID: 27540972 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bkWGgg
via IFTTT

Alcohol as a Risk Factor for Cancer.

Alcohol as a Risk Factor for Cancer.

Semin Oncol Nurs. 2016 Aug;32(3):325-31

Authors: Cao Y, Giovannucci EL

Abstract
OBJECTIVE: To summarize epidemiologic evidence of alcohol as a risk factor for many types of cancers and discuss available resources to help patients reduce alcohol intake.
DATA SOURCES: Published epidemiologic literature and resources available for alcohol reduction.
CONCLUSION: Heavy alcohol intake has been linked to increased risk of several cancers, including cancer of the colon, rectum, female breast, oral cavity, pharynx, larynx, liver, and esophagus; whereas light-to-moderate drinking (up to one drink per day for women and up to two drinks per day for men) is not appreciably associated with cancer risk and may be beneficial for cardiovascular disease. Among the healthy population and cancer survivors, those already drinking in moderation may continue to do so. Interactive tools can be used to track drinking and set goals for reducing alcohol intake. Medications and social support are available for alcoholics.
IMPLICATIONS FOR NURSING PRACTICE: Nurses may utilize epidemiologic evidence and resources available to educate patients about their cancer risk associated with alcohol intake and provide support for reducing intake.

PMID: 27539286 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bBrxTw
via IFTTT

Effects of Smoke Generated by Electrocautery on the Larynx.

Effects of Smoke Generated by Electrocautery on the Larynx.

J Voice. 2016 Aug 15;

Authors: Atar Y, Salturk Z, Kumral TL, Uyar Y, Cakir C, Sunnetci G, Berkiten G

Abstract
OBJECTIVE: The aim of this study was to investigate effects of smoke produced by electrocautery on the laryngeal mucosa.
MATERIALS AND METHODS: We used 16 healthy, adult female Wistar albino rats. We divided the rats into two groups. Eight rats were exposed to smoke for 60 min/d for 4 weeks, and eight rats were not exposed to smoke and served as controls. The experimental group was maintained in a plexiglass cabin during exposure to smoke. At the end of 4 weeks, rats were sacrificed under high-dose ketamine anesthesia. Each vocal fold was removed. An expert pathologist blinded to the experimental group evaluated the tissues for the following: epithelial distribution, inflammation, hyperplasia, and metaplasia. Mucosal cellular activities were assessed by immunohistochemical staining for Ki67. Results taken before and after effect were compared statistically.
RESULTS: There was a significant difference in the extent of inflammation between the experimental group and the control group. Squamous metaplasia was detected in each group, but the difference was not significant. None of the larynges in either group developed hyperplasia.
CONCLUSIONS: We showed increased tissue inflammation due to irritation by the smoke.

PMID: 27539002 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bBn6rT
via IFTTT

Detection and density estimation of goblet cells in confocal endoscopy for the evaluation of celiac disease.

Related Articles

Detection and density estimation of goblet cells in confocal endoscopy for the evaluation of celiac disease.

Conf Proc IEEE Eng Med Biol Soc. 2015;2015:6248-51

Authors: Boschetto D, Mirzaei H, Leong RW, Grisan E

Abstract
Celiac Disease (CD) is an immune-mediated enteropathy, diagnosed in the clinical practice by intestinal biopsy and the concomitant presence of a positive celiac serology. Confocal Laser Endomicroscopy (CLE) allows skilled and trained experts to potentially perform in vivo virtual histology of small-bowel mucosa. In particular, it allows the qualitative evaluation of mucosa alteration such as a decrease in goblet cells density, presence of villous atrophy or crypt hypertrophy. We present a semi-automatic computer-based method for the detection of goblet cells from confocal endoscopy images, whose density changes in case of pathological tissue. After a manual selection of a suitable region of interest, the candidate columnar and goblet cells' centers are first detected and the cellular architecture is estimated from their position using a Voronoi diagram. The region within each Voronoi cell is then analyzed and classified as goblet cell or other. The results suggest that our method is able to detect and label goblet cells immersed in a columnar epithelium in a fast, reliable and automatic way. Accepting 0.44 false positives per image, we obtain a sensitivity value of 90.3%. Furthermore, estimated and real goblet cell densities are comparable (error: 9.7 ± 16.9%, correlation: 87.2%, R(2) = 76%).

PMID: 26737720 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bkWGwM
via IFTTT

Modulating Effect of Peptide Therapy on the Morphofunctional State of Bronchial Epithelium in Rats with Obstructive Lung Pathology.

Related Articles

Modulating Effect of Peptide Therapy on the Morphofunctional State of Bronchial Epithelium in Rats with Obstructive Lung Pathology.

Bull Exp Biol Med. 2015 Sep;159(5):685-8

Authors: Kuzubova NA, Lebedeva ES, Dvorakovskaya IV, Surkova EA, Platonova IS, Titova ON

Abstract
On the model of chronic obstructive pulmonary disease, the effect of therapy with low-molecular-weight peptides on restructuring and functional activity of bronchial epithelium for restoring the immune and barrier function of the lungs and prevention of inflammatory process progression was studied. Chronic obstructive pulmonary disease was modeled in rats by 60-day intermittent exposure to NO2. Administration of tetrapeptide Bronchogen for 1 month eliminates symptoms of remodeling of the bronchial epithelium and lung tissue typical of chronic obstructive pulmonary disease (goblet cell hyperplasia, squamous metaplasia, lymphocytic infiltration and emphysema, and restoration of ciliated cells). Enhanced production of secretory IgA, a local immunity marker, attested to normalization of functional activity of bronchial epithelium, while normalization of cell composition and profile of proinflammatory cytokines in the bronchoalveolar space reflected reduction of neutrophilic inflammation.

PMID: 26468022 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bBtFdI
via IFTTT

Open partial horizontal laryngectomy for salvage after failure of CO₂ laser-assisted surgery for glottic carcinoma.

Related Articles

Open partial horizontal laryngectomy for salvage after failure of CO₂ laser-assisted surgery for glottic carcinoma.

Eur Arch Otorhinolaryngol. 2016 Jan;273(1):169-75

Authors: Lucioni M, Bertolin A, Lionello M, Giacomelli L, Rizzotto G, Marioni G

Abstract
Total laryngectomy (TL) is often still recommended as a salvage approach for recurrent laryngeal squamous cell carcinoma (LSCC). Considering LSCC recurrences after the failure of primary transoral laser microsurgery (TLM), open partial horizontal laryngectomy (OPHL) could be a valid alternative to TL in selected patients. The aim of the present study was to analyze retrospectively the oncological outcome of a consecutive series of 17 patients treated at the Otolaryngology Unit of Vittorio Veneto Hospital (Italy) with OPHL after primary TLM had failed. Nine patients (53 %) had no further recurrences after salvage OPHL. Eight patients had a second recurrence of LSCC after OPHL, and five of them were cured by further salvage treatment, while the other three died of their disease. We found an overall and disease-specific survival both of 82 % and a loco-regional control rate and an ultimate organ preservation rate of 82 and 70 %, respectively. Patients who underwent two-stage bilateral cordectomy for primary glottic carcinoma showed a trend towards a higher rate of second recurrences, a lower ultimate organ preservation rate and a shorter disease-free survival after salvage OPHL. Further studies on larger cohorts of patients are needed to identify potential clinical and/or pathological prognostic parameters capable of pinpointing patients at higher risk of second recurrences after salvage OPHL in cases where TLM has failed. A salvage TL might be reasonably proposed as a first salvage choice in such cases.

PMID: 26294221 [PubMed - indexed for MEDLINE]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bkWFZK
via IFTTT

Quantitative analysis of craniofacial dysmorphology in infants with anterior synostotic plagiocephaly.

Quantitative analysis of craniofacial dysmorphology in infants with anterior synostotic plagiocephaly.

Childs Nerv Syst. 2016 Aug 19;

Authors: Calandrelli R, D'Apolito G, Massimi L, Gaudino S, Visconti E, Pelo S, Di Rocco C, Colosimo C

Abstract
PURPOSE: The study aimed to identify premature synostosis of "major" and "minor" sutures of the coronal sutural arch and splanchnocranium sutures to evaluate the relationship between craniofacial dysmorphology and the sutural pattern in children with anterior plagiocephaly.
METHODS: A quantitative analysis of the skull base and facial changes was performed on preoperative high-resolution CT images in 18 children with anterior synostotic plagiocephaly and compared with imaging findings in 18 age-matched healthy subjects.
RESULTS: All patients had patent splanchnocranium sutures. Fifteen out of 18 children showed early and isolated synostosis of the unicoronal suture (the major suture of the coronal ring) and were classified in groups II and III according to the classification scheme of anterior synostotic plagiocephaly based on the severity of craniofacial dysmorphology. Premature fusion of the unilateral coronal suture in groups II and III caused a marked asymmetry and reduced growth of the anterior and middle fossae on the synostotic side and a secondary varying severity in terms of asymmetric growth of the facial complex. Although both groups showed anterior displacement of the mandibular articulation on the synostotic side, group II showed only maxillary asymmetry, while group III showed maxillary and mandibular asymmetry.
CONCLUSIONS: In anterior synostotic plagiocephaly, the severity of skull base changes and asymmetric growth of the facial complex is not caused by skull base sutural synostotic involvement but is probably related to the different timing of unilateral coronal suture closure.

PMID: 27541866 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bpJyWe
via IFTTT

Cranial Nerve Schwannomas: Diagnostic Imaging Approach.

Cranial Nerve Schwannomas: Diagnostic Imaging Approach.

Radiographics. 2016 Aug 19;:150199

Authors: Skolnik AD, Loevner LA, Sampathu DM, Newman JG, Lee JY, Bagley LJ, Learned KO

Abstract
Schwannomas are benign nerve sheath tumors that may arise along the complex course of the cranial nerves (CNs), anywhere in the head and neck. Sound knowledge of the CN anatomy and imaging features of schwannomas is paramount for making the correct diagnosis. In this article, we review approaches to diagnosing CN schwannomas by describing their imaging characteristics and the associated clinical presentations. Relevant anatomic considerations are highlighted by using illustrative examples and key differential diagnoses categorized according to regions, which include the anterior skull base, orbit, cavernous sinus, basal cisterns, and neck. The clinical presentations associated with CN schwannomas vary and range from no symptoms to symptoms caused by mass effect or CN deficits. Individuals with the inherited disorder neurofibromatosis type 2 are predisposed to multiple schwannomas. When a lesion follows the course of a CN, the radiologist's roles are to confirm the imaging features of schwannoma and exclude appropriate differential considerations. The characteristic imaging features of CN schwannomas reflect their slow growth as benign neoplasms and include circumscribed margins, displacement of local structures, and smooth expansion of osseous foramina. These neoplasms exhibit various degrees of solid enhancement, often with internal cystic spaces on magnetic resonance (MR) and computed tomographic (CT) images and heterogeneous high signal intensity specifically on T2-weighted MR images. Clinical and/or imaging evidence of end-organ compromise of the involved CN may exist and aid in the identification of the nerve of origin. With a detailed understanding of the course of the CNs, the diagnostic features of CN schwannomas, and the correlation between these data and the associated clinical presentations of these tumors, the radiologist can have a key role in the diagnosis of CN schwannomas and the treatment planning for affected patients. (©)RSNA, 2016.

PMID: 27541436 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b7Ti7T
via IFTTT

[Administration of S-1 Monotherapy as Adjuvant Chemotherapy in a Patient with Advanced Gastric Cancer with HIV Infection].

[Administration of S-1 Monotherapy as Adjuvant Chemotherapy in a Patient with Advanced Gastric Cancer with HIV Infection].

Gan To Kagaku Ryoho. 2016 Aug;43(8):995-7

Authors: Amaki M, Yajima K, Iwasaki Y, Ken Y, Oohinata R, Imamura A

Abstract
A 64-year-old man with advanced gastric cancer presented with chief complaints of chest pain. His preoperative blood examination revealed positive results for serum HIV-antibody. His HIV-RNA level was 1.0×10 / 5 copies/mL, and his CD4lymphocyte count was 491 cell/mL; the patient was diagnosed with advanced gastric cancer and HIV infection. Distal gastrectomy with D2 lymphadenectomy and Roux-en-Y reconstruction were performed for treatment of the gastric cancer. Pathological examination revealed T3(SS)N3aM0, Stage III C cancer. After surgery, the patient was administered S-1 monotherapy as adjuvant treatment with antiretroviral therapy including tenofovir/emtricitabine and raltegravir. He completed 8 courses of S- 1 chemotherapy with no adverse events, such as a decrease in the CD4lymphocyte count or an increase in the HIV-RNA level. This patient with gastric cancer and HIV infection was safely treated using both antiretroviral therapy and chemotherapy owing to treatment intervention by chemotherapy and infectious diseases specialists.

PMID: 27539043 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bBqnY6
via IFTTT

Autosomal dominant osteopetrosis associated with renal tubular acidosis is due to a CLCN7 mutation.

Autosomal dominant osteopetrosis associated with renal tubular acidosis is due to a CLCN7 mutation.

Am J Med Genet A. 2016 Aug 19;

Authors: Piret SE, Gorvin CM, Trinh A, Taylor J, Lise S, Taylor JC, Ebeling PR, Thakker RV

Abstract
The aim of this study was to identify the causative mutation in a family with an unusual presentation of autosomal dominant osteopetrosis (OPT), proximal renal tubular acidosis (RTA), renal stones, epilepsy, and blindness, a combination of features not previously reported. We undertook exome sequencing of one affected and one unaffected family member, followed by targeted analysis of known candidate genes to identify the causative mutation. This identified a missense mutation (c.643G>A; p.Gly215Arg) in the gene encoding the chloride/proton antiporter 7 (gene CLCN7, protein CLC-7), which was confirmed by amplification refractory mutation system (ARMS)-PCR, and to be present in the three available patients. CLC-7 mutations are known to cause autosomal dominant OPT type 2, also called Albers-Schonberg disease, which is characterized by osteosclerosis, predominantly of the spine, pelvis and skull base, resulting in bone fragility and fractures. Albers-Schonberg disease is not reported to be associated with RTA, but autosomal recessive OPT type 3 (OPTB3) with RTA is associated with carbonic anhydrase type 2 (CA2) mutations. No mutations were detected in CA2 or any other genes known to cause proximal RTA. Neither CLCN7 nor CA2 mutations have previously been reported to be associated with renal stones or epilepsy. Thus, we identified a CLCN7 mutation in a family with autosomal dominant osteopetrosis, RTA, renal stones, epilepsy, and blindness. © 2016 Wiley Periodicals, Inc.

PMID: 27540713 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bpKbiM
via IFTTT

Cortical microcirculatory disturbance in the super acute phase of subarachnoid hemorrhage - In vivo analysis using two-photon laser scanning microscopy.

Cortical microcirculatory disturbance in the super acute phase of subarachnoid hemorrhage - In vivo analysis using two-photon laser scanning microscopy.

J Neurol Sci. 2016 Sep 15;368:326-33

Authors: Ishikawa M, Kajimura M, Morikawa T, Tsukada K, Tsuji T, Kusaka G, Tanaka Y, Suematsu M

Abstract
OBJECTIVE: Subarachnoid hemorrhage (SAH) causes cerebral ischemia and drastically worsens the clinical status at onset. However, the arterial flow is surprisingly well maintained on the cerebral surface. We investigated cortical microcirculatory changes in the super acute phase of SAH using two-photon laser scanning microscopy (TPLSM).
METHODS: SAH was induced at the skull base in 10 mice using a prone endovascular perforation model. Before SAH, and 1, 2, 5, 10, 20, 30 and 60min after SAH, the cortical microcirculation was observed with TPLSM through a cranial window. Diameters of penetrating and precapillary arterioles were measured and red blood cell (RBC) velocities in precapillary arterioles were analyzed using a line-scan method after administration of Q-dot 655 nanocrystals.
RESULTS: One minute after SAH, RBC velocity and flow in precapillary arterioles drastically decreased to <20% of the pre-SAH values, while penetrating and precapillary arterioles dilated significantly. Subsequently, the arterioles either dilated or constricted inconsistently for 60min with continual decreases in RBC velocity and flow in the arterioles, suggesting neurovascular dysfunction.
CONCLUSION: SAH caused sudden worsening of the cortical arteriolar velocity and flow at onset. The neurovascular unit cannot function sufficiently to maintain cortical microcirculatory flow in the super acute phase of SAH.

PMID: 27538658 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b5JmgP
via IFTTT

The role of long non-coding RNA HOTAIR in the progression and development of laryngeal squamous cell carcinoma interacting with EZH2.

The role of long non-coding RNA HOTAIR in the progression and development of laryngeal squamous cell carcinoma interacting with EZH2.

Acta Otolaryngol. 2016 Aug 19;:1-9

Authors: Zheng J, Xiao X, Wu C, Huang J, Zhang Y, Xie M, Zhang M, Zhou L

Abstract
CONCLUSIONS: The aberrant expression of long non-coding RNA HOTAIR and transmethylase EZH2 played important roles in the progression and development of laryngeal squamous cell carcinoma (LSCC).
OBJECTIVES: This research was aimed to explore the expression and correlation with clinicopathological characteristics of HOTAIR and EZH2 in LSCC, and to evaluate the function of the two in regulating the proliferation and cis-platinum resistance processes of LSCC.
METHODS: Quantitative real time-PCR (qPCR) was conducted to measure the expression of HOTAIR and EZH2 in tissue samples. Clinicopathological features were collected and statistically analyzed combining with the expression of HOTAIR and EZH2. The variance of EZH2 with down-regulating HOTAIR was measured by qPCR. CCK-8 proliferation test was conducted to detect the proliferation feature in LSCC cells. After cultured with a series of cis-platinum concentrations for 24 h, cell viability was detected using CCK-8 assay, and the inhibition rates were calculated.
RESULTS: HOTAIR and EZH2 were over-expressed in LSCC tissue. The higher expression was significantly related to T phase, pathological grades, and risk of lymphatic metastasis of LSCC. Suppressing HOTAIR expression stimulated EZH2 expressing, promoted the proliferation of AMC-HN8 cells, and increased the sensitivity to cis-platinum of the LSCC cells.

PMID: 27542077 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2b7dtQ7
via IFTTT

Taste disturbance after stapes surgery: an evaluation of frequency, severity, duration, and quality-of-life.

Taste disturbance after stapes surgery: an evaluation of frequency, severity, duration, and quality-of-life.

Acta Otolaryngol. 2016 Aug 19;:1-5

Authors: Berling Holm K, Knutsson J, Strömbäck K, Danckwardt Lillieström N, Papatziamos G, Rosenblad A, Von Unge M

Abstract
CONCLUSION: The incidence of taste disturbance after stapes surgery is high (61.9%), whereas the majority (94.8%) recovers within 1 year. More severe surgical nerve trauma caused more disturbance, implying that the nerve should be handled carefully during surgery.
OBJECTIVES: Patients operated on for otosclerosis seem more often to complain about post-operative taste disturbance than those operated on for chronic otitis media, although the chorda tympani nerve more seldom becomes maltreated in stapedotomy. These observations seem paradoxical. It is unclear to what extent a post-operative taste disturbance affects the quality-of-life. This study aims to shed light on the occurrence of post-operative taste disturbances, on possible prognostic factors, and to what extent post-operative taste disturbance impairs the quality-of-life.
METHODS: One hundred and thirty-four adults undergoing primary stapedotomy were included. Questionnaires on taste disturbance and quality-of-life (SF-36) were answered before and after surgery, until 1 year post-operatively.
RESULTS: Eighty-three (61.9%) study persons reported post-operative taste disturbance. Seven (5.2%) reported persisting disturbance at 1 year. Surgically more traumatized chorda tympani nerves correlated with more severe taste disturbance post-operatively than less traumatized. Taste disturbance at 1 year post-operatively correlate with a decrease of the physical function domain in the SF-36.

PMID: 27540683 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bpJwxL
via IFTTT

[Treatment Outcomes of Adult-Onset Ewing Sarcoma: A Single-Center Retrospective Study of Five Cases].

[Treatment Outcomes of Adult-Onset Ewing Sarcoma: A Single-Center Retrospective Study of Five Cases].

Gan To Kagaku Ryoho. 2016 Aug;43(8):1015-8

Authors: Murase K, Takada K, Kamihara Y, Usami M, Yoshida M, Tatekoshi A, Hashimoto A, Arihara Y, Hayasaka N, Miura S, Iyama S, Sato T, Sato Y, Miyanishi K, Kobune M, Emori M, Kaya M, Yamashita T, Sugita S, Hasegawa T, Kato J

Abstract
UNLABELLED: We report the treatment outcomes of 5 cases of adult-onset Ewing sarcoma(ES)managed between 2011 and 2014. We examined prognostic factors including the primary lesion, tumor size, metastatic status, and serum LDH levels.
RESULTS: The locations of the primary lesions included the limbs in 1 case and the trunk in 4; the cases in the trunk had a worse prognosis than that in the limbs. Tumor size was greater than 8 cm in only 1 patient, who also displayed evidence of metastases at presentation and high LDH levels. All the patients received chemotherapy consisting of alternating vincristine, doxorubicin, and cyclophosphamide(VDC)and etoposide and ifosfamide(IE). Surgery was selected for the treatment of 4 patients, and radiotherapy was administered to 1 patient for local treatment of the tumor. A median follow-up duration of 31.6 months revealed the 2-year overall survival rate and progression-free survival rate to be 80.0%.
CONCLUSIONS: The prognosis of patients with adult-onset ES is poor; however, combined modality therapy, including VDC-IE, was demonstrated to improve the outcome of patients in the present study. Nevertheless, the patient with tumor size exceeding 8 cm, metastasis, and high LDH levels, relapsed 1 year after treatment, as reported previously. Further investigation is required to clarify the factors affecting prognosis in adults, and to develop effective therapies for patients with a poor prognosis.

PMID: 27539047 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bBr2c7
via IFTTT

[A Case of Rectal Neuroendocrine Carcinoma with Metachronous Liver Metastasis Treated with Multimodality Therapy].

[A Case of Rectal Neuroendocrine Carcinoma with Metachronous Liver Metastasis Treated with Multimodality Therapy].

Gan To Kagaku Ryoho. 2016 Aug;43(8):1009-13

Authors: Miyamae Y, Shimizu H, Naganuma A, Aiba M, Tanaka T, Ogawa T, Ogawa A, Osamura Y

Abstract
A 6 2-year-old woman visited our hospital with a complaint of anal bleeding and was diagnosed with rectal cancer. She underwent low anterior resection and D3 lymphadenectomy. The pathological diagnosis was shown as follows: Ra, Circ, type 2, por1, pSS, ly3, v1, pN2, pStage III b, and KRAS wild type. UFT/UZEL with polysaccharide K(PSK)was initiated as adjuvant chemotherapy after the operation. However, multiple liver metastases were found on CT after 3 courses of UFT/UZEL with PSK, and pathological reexamination revealed that the primary tumor was a neuroendocrine carcinoma. She underwent chemotherapy with CBDCA combined with CPT-11, but bone marrow suppression was observed after 4 courses of the treatment. As second-line chemotherapy, FOLFOX4 plus panitumumab(Pmab)was administered. Although the disease remained stable through 10 courses of FOLFOX4 plus Pmab, Grade 3 peripheral neuropathy was observed. Hence, FOLFIRI plus bevacizumab(Bmab)was administered as third-line chemotherapy. Twenty-eight courses of FOLFIRI plus Bmab were administered, and transcatheter arterial chemoembolization(TACE)was performed during chemotherapy. However, her general condition worsened after the therapies, and she died 2 years 3 months after the initial chemotherapy.

PMID: 27539046 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bkVCJp
via IFTTT

[A Case of Liver Metastasis from Colorectal Cancer That Showed a Pathological Complete Response to mFOLFOX6 plus Cetuximab].

[A Case of Liver Metastasis from Colorectal Cancer That Showed a Pathological Complete Response to mFOLFOX6 plus Cetuximab].

Gan To Kagaku Ryoho. 2016 Aug;43(8):1003-7

Authors: Konishi K, Ikenaga M, Ohta K, Nakashima S, Nakagawa T, Endo S, Yamada T, Chihara T, Nishijima J

Abstract
A 68-year-old man was diagnosed with rectal cancer on colonoscopy and liver metastasis of rectal cancer on abdominal computed tomography(CT). He underwent resection of the primary lesion, and the final diagnosis was A, N1, H1, P0, M0, fStage IV. After resection of the primary lesion, he received chemotherapy with mFOLFOX6 plus cetuximab. After 6 courses of the treatment, CT revealed partial response of the liver metastasis. Then, he underwent resection of the liver metastasis. The pathological finding revealed that the resected specimen had no cancer cells. After resection of the liver metastasis, he received 6 courses of chemotherapy with the same regimen, and relapse-free survival continues until the time of this writing.

PMID: 27539045 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bBrqqR
via IFTTT

[Two Cases of Gastric Endocrine Cell Carcinoma].

[Two Cases of Gastric Endocrine Cell Carcinoma].

Gan To Kagaku Ryoho. 2016 Aug;43(8):999-1002

Authors: Tochimoto M, Watanabe T, Sadamura K, Iwaki Y, Horiguchi Y, Tawaraya K, Katoh H, Kawaguchi M, Hosokawa O, Yanagimoto K

Abstract
The first patient was a man in his eighties who visited our department because of anemia. Gastrofiberscopy revealed a bleeding submucosal tumor, approximately 50mm in diameter, in the cardia ofthe stomach. Considering that he underwent coronary-artery bypass surgery and received 3 oral antithrombotic medicines, his bleeding tendency was so high that we decided to choose partial gastrectomy. A postoperative histopathological examination revealed that the tumor was a small cell endocrine carcinoma. The second patient was a woman in her seventies. She had consulted her personal physician because of gastric ulcers; periodic gastrofiberscopy revealed a type 3 gastric cancer, approximately 40mm in diameter, on the posterior wall ofthe middle section ofher stomach. It was histologically diagnosed as a poorly differentiated neuroendocrine carcinoma. On a preoperative blood examination, the levels ofhormones such as glucagon, serotonin, and gastrin were within their respective normal limits. Total gastrectomy was performed, and she received oral S-1 for adjuvant chemotherapy since her discharge from the hospital.

PMID: 27539044 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bkVg5v
via IFTTT

[Excretion Management During Colorectal Cancer Chemotherapy].

[Excretion Management During Colorectal Cancer Chemotherapy].

Gan To Kagaku Ryoho. 2016 Aug;43(8):989-93

Authors: Koyama T, Kagawa Y, Shimokawa F, Funakoshi S, Nanbara M, Naito A, Hirooka T, Tachihara A, Watanabe M, Kano S, Takeda Y, Tamura S, Kato T, Ikeue H

Abstract
There are almost no reports about drug excretion management during colorectal cancer chemotherapy. Anticancer chemotherapeutic drugs excreted in urine and feces may exert toxic effects and promote teratogenesis, mutagenesis, and carcinogenesis. To assess the knowledge of patients about drug excretion, a questionnaire survey was performed among 45 patients receiving chemotherapy for colorectal cancer in our hospital; among them, 36 patients completed the survey. Most of the patients did not know about the excretion and toxic effects of anticancer drugs. The results indicate that patients should be instructed on the management ofexcretion during chemotherapy to minimize toxic exposure. We believe that unnecessary exposure of patients and their families to anticancer drugs should be minimized. This study highlights the importance of issuing guidelines regarding excretion management during cancer chemotherapy.

PMID: 27539042 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bkUEg9
via IFTTT

Assessment of Injection Site Reactions for Peripheral Intravenous Oxaliplatin Infusion and Potential Remedies.

Assessment of Injection Site Reactions for Peripheral Intravenous Oxaliplatin Infusion and Potential Remedies.

Gan To Kagaku Ryoho. 2016 Aug;43(8):985-8

Authors: Handa S, Kuroiwa R, Miyano M, Shimizu H, Kamei D, Takei H, Sonou H, Yamamoto H, Murayama J, Sato A, Kato Y

Abstract
We investigated the medical and nursing records of 19 patients with unresectable advanced recurrent colorectal cancers treated using oxaliplatin and capecitabine(CapeOX)with or without bevacizumab at the outpatient tumor center of Showa UniversityHospital between November 1, 2009 and November 30, 2011, to clarifydifferences in the incidence of injection site reactions according to the use or non-use of an intravenous infusion solution warming device. Vascular pain and other injection site reactions occurred in 13 patients(68.4%). Injection site reactions occurred in 33 of the total of 77 chemotherapytreatments (42.9%). No difference in incidence of injection site reactions was seen according to whether the intravenous infusion solution warmer was used. The most common time to onset of injection site reactions after commencing oxaliplatin administration was 60-90 min, and symptoms were seen to decrease when non-steroidal anti-inflammatorydrugs were coadministered. We intend to leverage these studyfindings to demonstrate the mechanism of onset for injection site reactions and to propose measures for handling adverse drug reactions.

PMID: 27539041 [PubMed - in process]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/2bBrqHG
via IFTTT